Key result
Antidepressant use linked to ~34% greater risk of ventricular arrhythmia or sudden cardiac death.
Why the study?
Evidence on the association between antidepressant use and the risk of atrial fibrillation and ventricular arrhythmia/sudden cardiac death remains inconsistent.
Does antidepressant use increase the risk of atrial fibrillation and ventricular arrhythmia/sudden cardiac death compared to non-use?
Meta-Analysis (n=9,619,278)
Does antidepressant use increase the risk of atrial fibrillation and ventricular arrhythmia/sudden cardiac death compared to non-use?
Odds Ratio: 1.34 (95% CI 1.15–1.55)
Antidepressant use, including SSRIs and TCAs, is associated with an increased risk of ventricular arrhythmia and sudden cardiac death, highlighting the need for careful cardiovascular risk assessment when prescribing these medications.
Antidepressant use was associated with higher atrial fibrillation risk but not ventricular arrhythmia/sudden death; leaves open causality and requires prospective trials.
BACKGROUND: Antidepressants (ADs) have been associated with adverse cardiovascular effects, including cardiac arrhythmias. Evidence on the association between AD use and the risk of atrial fibrillation (AF) and ventricular arrhythmia/sudden cardiac death (VA/SCD) remains inconsistent. This systematic review and meta-analysis aimed to evaluate the relationship between AD use and the risk of AF and VA/SCD. METHODS: A detailed search was conducted in PubMed, Scopus, and Web of Science till June 2026. Cohort and case-control studies comparing AD users with non-users and reporting AF, VA, or SCD as outcomes were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Twelve studies with 9,619,278 participants were included. AD use was associated with a significantly increased risk of VA/SCD (9 studies, 6,373,522 participants, OR = 1.34, 95% CI: 1.15-1.55; I² = 90.5%). The association remained significant for both SSRIs and TCAs. For AF, no overall significant association emerged (3 Studies, 3,245,756 participants, OR = 1.75, 95% CI: 0.84-3.62; I² = 98.1%). However, sensitivity analysis excluding one influential study showed a significant association with AF (2 Studies, 18,109 participants, OR = 1.27, 95% CI: 1.07-1.50) and eliminated heterogeneity (I² = 0%). CONCLUSION: This meta-analysis suggests an association between AD use and an increased risk of VA/SCD, while evidence for AF remains uncertain because the results were influenced by a single study. Future large observational studies that better address confounding by indication and adequately adjust for depression are needed to provide more robust evidence.
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Amirat et al. (2026) conducted a meta-analysis in Atrial fibrillation and ventricular arrhythmia/sudden cardiac death (n=9,619,278). Antidepressants vs. Non-users was evaluated on Ventricular arrhythmia/sudden cardiac death (VA/SCD) (OR 1.34, 95% CI 1.15-1.55). Antidepressant use was associated with a significantly increased risk of ventricular arrhythmia or sudden cardiac death (OR 1.34; 95% CI 1.15-1.55).
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